EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Clay County Fairgrounds Hurricane Roof Repairs – Exhibit Hall 2 & Cattlemen’s Arena
Solicitation number
25/26-055
Issued by
Clay County, Harold CDP, Florida

About this file

This is an Electronic Funds Transfer (EFT) Authorization Form issued by the Clay County Clerk of Court and Comptroller in Florida for processing vendor payments. The form authorizes Clay County's Comptroller Department and the vendor's financial institution to initiate electronic credits and debits for contract payments. Vendors must provide complete banking information including the financial institution name, account type, routing/ABA number, and account number. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. Vendors are required to notify the Comptroller immediately if their bank account is closed or changed. Individuals may obtain necessary EFT information from their financial institution via direct deposit letters or voided checks, while businesses and vendors should contact their financial institution for complete ACH/EFT details.

This form is a standard administrative requirement for vendors contracting with Clay County and is directly related to the County's hurricane roof repair project at the Clay County Fairgrounds (IFB #25/26-055). Contractors awarded this federally-funded FEMA project will receive monthly payments based on work completed in accordance with the Florida Local Government Prompt Payment Act, necessitating submission of valid EFT authorization prior to contract execution. The form is a prerequisite for payment processing and does not affect bid submission requirements, bond obligations, insurance requirements, or other contractual terms associated with the roofing repair project.

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Text version

Clay County Clerk of Court and Comptroller

EFT Authorization Form

Individual/Business/Vendor Name: (Please Print)

Phone Number:

Email:

I/We hereby authorize Clay County Comptrollers and the financial institution listed below to initiate electronic credits, and, if necessary, debit entries and adjustments for any credit entries in error. This authority will remain in effect until I cancel it in writing to the Comptroller Department. *Notify the Comptroller Department immediately if you close or change Bank Account*

Account Information:

Financial Institution:

Type of Account (please circle one): Checking Savings Other:______________

Transit / ABA / Routing #:

Account Number:

*Individuals: If you are unsure of your complete EFT information please contact your financial institution. In most cases, your financial institution can provide you with a direct deposit/EFT letter or a voided check.

Businesses/Vendors: Please check with your financial institution for your complete ACH/EFT information.

Authorized Signature:_______________________________ Date: ___________

File details come from the government source that posted it. Updated .